Provider Demographics
NPI:1104276054
Name:ECHEMA IBE, LOVE UGONMA (FNP)
Entity type:Individual
Prefix:
First Name:LOVE
Middle Name:UGONMA
Last Name:ECHEMA IBE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LOVE
Other - Middle Name:
Other - Last Name:ECHEMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:2001 SANTA MONICA BLVD
Mailing Address - Street 2:280W
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2102
Mailing Address - Country:US
Mailing Address - Phone:310-829-7678
Mailing Address - Fax:310-829-6889
Practice Address - Street 1:2001 SANTA MONICA BLVD STE 280W
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2172
Practice Address - Country:US
Practice Address - Phone:310-829-7678
Practice Address - Fax:310-829-6889
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001275363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily